Objective: Population studies have shown increase in somatization among the old aged population in Korea. The aim of the study was to investigate the contribution of somatosensory amplification and symptom interpretation on somatization in elderly patients.
Design: The tendencies of somatosensory amplification and symptom interpretation between the elderly and the young psychiatric patient groups were compared. Whether the somatosensory amplification and the symptom interpretation differ in predicting somatization in these groups was also investigated.
Materials and Methods: The study population consisted of 173 consecutive patients, who first were presented with medically unexplained physical symptoms to a university hospital and then were referred to a psychosomatic clinic. The following measures were used: the Somatosensory Amplification Scale (SSAS), the Symptom Interpretation Questionnaire(SIQ), and the Symptom Checklist-90-R (SCL-90-R). Comparisons of the total score of SSAS and the four subscales of SIQ between the young and the elderly groups were done. In addition, regression analyses were run with the total score of SSAS and the four subscales of SIQ predicting somatization in both groups
RESULT: Thirty-three cognitively unimpaired elderly patients (mean age=58.7, SD=7.0) were compared with one hundred forty young patients(mean age=36.0, SD=8.3). Using the t-test, the mean SIQ psychological score and SIQ neutral score of young group (M=2.6, SD=0.5 & M=2.1, SD=0.4, respectively) were significantly higher than that of the elderly group (M=2.3, SD=0.5 & M=1.8, SD=0.4, respectively) (p=0.004 & p=0.002, respectively). In the elderly group, only the total score of SSAS predicted somatization(adjusted R2=12.4%, b=0.390, t=2.321, p=0.027). Whereas in the young group, psychological interpretation subscale (adjusted R2=20.7%, b=0.455, t=5.979, p=0.000), catastrophic subscale (adjusted R2=9.1%, b=0.314, t=4.201, p=0.000), and the total score of SSAS (adjusted R2=3.5%, b=0.220, t=2.644, p=0.009) predicted somatization.
Conclusion:
In our study, young somatizers were revealed to have an increased tendency than elders to interpretate their physical symptoms to be related with psychological or environmental factors. In terms of the amplification of physical symptoms, there was no difference among these two groups. In addition, factors to contribute to somatization of both young and elder groups revealed to have different construct. Further studies are needed to clarify the age-specific cognitive characteristics causing somatization
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